ArticleFrontiers in pediatrics2026
Cerebrovascular thrombosis during pediatric ALL therapy: a case series highlighting temporal association with PEG-asparaginase exposure.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Cerebrovascular thrombosis is an uncommon but potentially life-threatening complication of chemotherapy in children with acute lymphoblastic leukemia (ALL). Although PEG-asparaginase-associated thrombosis has been widely recognized, the temporal pattern, laboratory evolution, and management characteristics of cerebrovascular events remain incompletely described. Methods: We conducted a retrospective single-center case series of pediatric patients with acute lymphoblastic leukemia (ALL) treated between January 2018 and December 2025. Clinical records, serial coagulation parameters, neuroimaging findings, treatment strategies, and outcomes of patients who experienced cerebrovascular thrombotic events during chemotherapy were reviewed descriptively. Results: Among 1,138 pediatric patients with ALL treated during the study period, six developed radiologically confirmed cerebrovascular thrombosis (incidence proportion, 0.53%; median age, 10 years). Five patients developed cerebral venous sinus thrombosis (CVST) and one developed acute ischemic stroke (AIS). Five of six events in this small cohort occurred within 5-17 days after PEG-asparaginase administration. At symptom onset, all patients exhibited markedly elevated D-dimer levels and reduced antithrombin III (AT-III) activity. Following treatment, D-dimer levels declined within 1-3 days, whereas AT-III activity recovered more gradually over 5-13 days. Four patients with CVST received therapeutic low-molecular-weight heparin and achieved favorable neurological outcomes. One patient with AIS underwent successful mechanical thrombectomy with substantial neurological improvement. No recurrent thrombotic events were observed during follow-up. Conclusions: In this case series, cerebrovascular thrombosis during pediatric ALL therapy showed a distinct temporal clustering pattern within 5-17 days after PEG-asparaginase exposure and was consistently associated with reduced AT-III activity and elevated D-dimer levels. These findings suggest a potential high-risk period during which focused coagulation monitoring may facilitate earlier diagnosis and timely therapeutic intervention.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.